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  • 101.
    Anens, Elisabeth
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Kristensen, Bo
    Häger-Ross, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Reactive grip force control in persons with cerebellar stroke: effects on ipsilateral and contralateral hand2010In: Experimental Brain Research, ISSN 0014-4819, E-ISSN 1432-1106, Vol. 203, no 1, p. 21-30Article in journal (Refereed)
    Abstract [en]

    This study investigates the cerebellar contribution to reactive grip control by examining differences between (22-48 years) subjects with focal cerebellar lesion due to ischaemic stroke (CL) and healthy subjects (HS). The subjects used a pinch grip to grasp and restrain an instrumented handle from moving when it was subject to unpredictable load forces of different rates (2, 4, 8, 32 N/s) or amplitudes (1, 2, 4 N). The hand ipsilateral to the lesion of the cerebellar subjects showed delayed and more variable response latencies, e.g., 278 +/- 162 ms for loads delivered at 2 N/s, compared to HS 180 +/- 53 ms (P = 0.005). The CL also used a higher pre-load grip force with the ipsilateral hand, 1.6 +/- 0.8 N, than the HS, 1.3 +/- 0.6 N (P = 0.017). In addition, the contralateral hand in subjects with unilateral cerebellar stroke showed a delayed onset of the grip response compared to HS. Cerebellar lesions thus impair the reactive grip control both in the ipsilateral and contralateral hand.

  • 102.
    Appelvik, Emma
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Ericsson, Emma
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Internetbaserade insatser och dess effekter på äldre: En litteraturstudie2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Utvecklingen av ny teknik som datorer och Internet går snabbt framåt och i dagsläget är många varor och tjänster enbart eller delvis tillgängliga via denna teknik. Mätningar har visat att äldre personer över 65 år använder Internet i betydligt lägre grad än de i yrkesverksam ålder. Dessa skillnader i användning gör att äldres hälsa och delaktighet i samhället kan påverkas negativt. För att den nya digitala tekniken ska kunna gynna äldre krävs att de ges möjligheten att lära sig hur den används och vilka fördelar den kan medföra. Syftet med denna studie var därför att identifiera och beskriva insatser som genomförts för att bibehålla eller utveckla äldres aktivitet, hälsa och delaktighet via Internet samt effekterna av dessa. Metoden som använts är en beskrivande litteraturstudie bestående av åtta vetenskapliga artiklar. Vid analys av data framkom interventioner som gjorts i grupp, individuella interventioner samt interventioner med både inslag av individ -och grupp moment. Vidare fanns även karaktäristiska likheter och skillnader i effekter vilka var minskad känsla av ensamhet och depression, ökat självförtroende och självkänsla samt ökad känsla av delaktighet. Resultatet visar att interventioner i grupp var vanliga samt att Interventioner med olika utformning och syften resulterade i likartade effekter.

  • 103. Arkkukangas, Marina
    et al.
    Sundler, Annelie J.
    Soderlund, Anne
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden; Department of Neuroscience, Physiotherapy, Uppsala University, Uppsala, Sweden.
    Johansson, Ann-Christin
    Older persons' experiences of a home-based exercise program with behavioral change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

    Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons.

    Purpose: This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change.

    Methods: Semi-structured interviews were conducted with 12 elderly persons aged 75years or older, and a qualitative content analysis was performed.

    Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    Conclusion: With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

  • 104. Arkkukangas, Marina
    et al.
    Söderlund, Anne
    Eriksson, Staffan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden; Uppsala Univ, Dept Neurosci, Physiotherapy, Sweden.
    Johansson, Ann-Christin
    One-year adherence to the Otago Exercise Program with or without motivational interviewing in community-dwelling older adults2018In: Journal of Aging and Physical Activity, ISSN 1063-8652, E-ISSN 1543-267X, Vol. 26, no 3, p. 390-395Article in journal (Refereed)
    Abstract [en]

    This study investigated if behavioral factors, treatment with behavioral support, readiness to change, fall self-efficacy, and activity habits could predict long-term adherence to an exercise program. Included in this study were 114 community-dwelling older adults who had participated in one of two home-based exercise interventions. Behavioral factors associated with adherence to the exercise program over 52 weeks were analyzed. The behavioral factors, specifically activity habits at baseline, significantly predicted adherence to the exercise program, with an odds ratio = 3.39, 95% confidence interval [1.38, 8.32], for exercise and an odds ratio = 6.11, 95% confidence interval [2.34, 15.94], for walks. Being allocated to a specific treatment including motivational interviewing was also significantly predictive: odds ratio = 2.47, 95% confidence interval [1.11, 5.49] for exercise adherence. In conclusion, activity habits and exercise in combination with motivational interviewing had a significant association with adherence to the exercise program at a 1-year follow-up.

  • 105.
    Arnadottir, Gudrun
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Dimensionality of nonmotor neurobehavioral impairments when observed in the natural contexts of ADL task performance2009In: Neurorehabilitation and neural repair, ISSN 1545-9683, Vol. 23, no 6, p. 579-586Article in journal (Refereed)
    Abstract [en]

    Objective. To examine diverse nonmotor neurobehavioral impairments (NBIs) that impact activities of daily living (ADL) task performance and to verify if such impairments can be viewed as one dimension when evaluated in an ecologically-relevant context. Methods. Rasch analysis was performed on data from 206 individuals diagnosed with dementia or cerebral vascular accident (CVA) who had been scored on 50 standardized NBIs from the A-ONE Neurobehavioral Impairment scale, based on naturalistic observation of ADL task performance. Evaluation of mean square (MnSq) infit and outfit values and principal components analysis (PCA) of residuals were used to evaluate unidimensionality of the items. Two evaluations were implemented: (1) to evaluate if there is a single global dimension common for persons with either dementia or CVA, and (2) to evaluate if the 50 NBIs are unidimensional, but comprised of different diagnosis-specific global hierarchies (dementia, left CVA, and right CVA). Results. The PCA indicated that 56.8% of variance was explained by the global measure (Rasch factor) of NBIs, with 4.9% of the unexplained variance explained by the first contrast. Four items showed outfit misfit to the common hierarchy. Developing diagnosis-specific global hierarchies resulted in improved PCA results for all 3 diagnostic groups (Rasch factor = 79.2% to 85.5%; unexplained variance in first contrast = 1.7% to 3.4%) after removal of 2 to 3 misfitting items. Conclusions. Nonmotor NBIs, when evaluated based on naturalistic performance of ADL, can be considered unidimensional, but the hierarchical structure of the dimension likely varies across diagnostic groups. Further study is needed with larger samples to verify these results.

  • 106.
    Arnadottir, Gudrun
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Occupational Therapy.
    Löfgren, B
    Fisher, AG
    Difference in impact of neurobehavioral dysfunction on ADL performance between persons with right and left hemispheric strokeManuscript (preprint) (Other academic)
  • 107.
    Arnadottir, Gudrun
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Löfgren, Britta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne G.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Neurobehavioral functions evaluated in naturalistic contexts: Rasch analysis of the A-ONE Neurobehavioral Impact Scale2012In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 19, no 5, p. 439-449Article in journal (Refereed)
    Abstract [en]

    Objective: The fact that different neurobehavioral impairments affect daily life task performance of clients with different neurological diagnoses currently restricts between-group comparisons in rehabilitation. The purpose of this study was to determine whether a single neurobehavioral impact scale could be constructed for use with different diagnostic groups. Methods and results. Rasch analysis of 422 clients (diagnosed with CVA and dementia) demonstrated that 29 of 55 items from the A-ONE Neurobehavioral Scale could be used to construct a short-form, Common Scale. Conclusions: While the use of different and longer diagnostic-specific scales versions may be more useful clinically, the short-form, Common Scale has the potential to be used in research focusing on comparison of groups. Further research will be needed to validate the common, short version.

  • 108.
    Arnadottir, Solveig
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Physical activity, participation and self-rated health among older community-dwelling Icelanders: a population-based study2010Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: The main objective of this study was to investigate older people’s physical activity, their participation in various life situations, and their perceptions of their own health. This included an exploration of potential influences of urban versus rural residency on these outcomes, an evaluation of the measurement properties of a balance confidence scale, and an examination of the proposed usefulness of the International Classification of Functioning, Disability and Health (ICF) as a conceptual framework to facilitate analysis and understanding of selected outcomes.

    Methods: The study design was cross-sectional, population-based, with random selection from the national register of one urban and two rural municipalities in Northern Iceland. There were 186 participants, all community-dwelling, aged 65 to 88 years (mean = 73.8), and 48% of the group were women. The participation rate was 79%. Data was collected in 2004, in face-to-face interviews and through various standardized assessments. The main outcomes were total physical activity; leisure-time, household, and work-related physical activity; participation frequency and perceived participation restrictions; and self-rated health. Other assessments represented aspects of the ICF body functions, activities, environmental factors and personal factors. Moreover, Rasch analysis methods were applied to examine and modify the Activities-specific Balance Confidence (ABC) scale and the ICF used as a conceptual framework throughout the study.

    Results: The total physical activity score was the same for urban and rural people and the largest proportion of the total physical activity behavior was derived from the household domain. Rural females received the highest scores of all in household physical activity and rural males were more physically active than the others in the work-related domain. However, leisure-time physical activity was more common in urban than rural communities. A physically active lifestyle, urban living, a higher level of cognition, younger age, and fewer depressive symptoms were all associated with more frequent participation. Rural living and depressive symptoms were associated with perceived participation restrictions. Moreover, perceived participation restrictions were associated with not being employed and limitations in advanced lower extremity capacity. Both fewer depressive symptoms and advanced lower extremity capacity also increased the likelihood of better self-rated health, as did capacity in upper extremities, older age, and household physical activity. Rasch rating scale analysis indicated a need to modify the ABC to improve its psychometric properties. The modified ABC was then used to measure balance confidence which, however, was found not to play a major role in explaining participation or self-rated health. Finally, the ICF was useful as a conceptual framework for mapping various components of functioning and health and to facilitate analyses of their relationships.

    Conclusions: The results highlighted the commonalities and differences in factors associated with participation frequency, perceived participation restrictions, and self-rated health in old age. Some of these factors, such as advanced lower extremity capacity, depressive symptoms, and physical activity pattern should be of particular interest for geriatric physical therapy due to their potential for interventions. While the associations between depressive symptoms, participation, and self-rated health are well known, research is needed on the effects of advanced lower extremity capacity on participation and self-rated health in old age. The environment (urban versus rural) also presented itself as an important contextual variable to be aware of when working with older people’s participation and physically active life-style. Greater emphasis should be placed on using Rasch measurement methods for improving the availability of quality scientific measures to evaluate various aspects of functioning and health among older adults. Finally, a coordinated implementation of a conceptual framework such as ICF may further advance interdisciplinary and international studies on aging, functioning, and health.

  • 109.
    Arnadottir, Solveig A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsdottir, Elin D
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Are rural older Icelanders less physically active than those living in urban areas?: a population-based study2009In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 37, no 4, p. 409-417Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Older people in rural areas have been labelled as physically inactive on the basis of leisure-time physical activity research. However, more research is needed to understand the total physical activity pattern in older adults, considering all domains of physical activity, including leisure, work, and domestic life. AIMS: We hypothesised that: (a) total physical activity would be the same for older people in urban and rural areas; and (b) urban and rural residency, along with gender and age, would be associated with differences in domain-specific physical activities. METHODS: Cross-sectional data were collected in Icelandic rural and urban communities from June through to September 2004. Participants were randomly selected, community-dwelling, 65-88 years old, and comprised 68 rural (40% females) and 118 urban (53% females) adults. The Physical Activity Scale for the Elderly (PASE) was used to obtain a total physical activity score and subscores in leisure, during domestic life, and at work. RESULTS: The total PASE score was not associated with rural vs. urban residency, but males were, in total, more physically active than females, and the 65-74-year-olds were more active than the 75-88-year-olds. In the leisure domain, rural people had lower physical activity scores than urban people. Rural males were, however, most likely of all to be physically active in the work domain. In both urban and rural areas, the majority of the physical activity behaviour occurred in relation to housework, with the rural females receiving the highest scores. CONCLUSIONS: Older Icelanders in rural areas should not be labelled as less physically active than those who live in urban areas. Urban vs. rural living may, however, influence the physical activity patterns among older people, even within a fairly socioeconomically and culturally homogeneous country such as Iceland. This reinforces the need to pay closer attention to the living environment when studying and developing strategies to promote physical activity.

  • 110.
    Arnadottir, Solveig A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy. School of Health Sciences, University of Akureyri, Iceland .
    Gunnarsdottir, Elin D
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Determinants of self-rated health in old age: a population-based, cross-sectional study using the international classification of functioning2011In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 11, p. 670-Article in journal (Refereed)
    Abstract [en]

    Background: Self-rated health (SRH) is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF) to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas.

    Methods: The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF.

    Results: Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, < 0.001), upper extremity capacity (adjOR = 1.13, = 0.040), household physical activity (adjOR = 1.01, = 0.016), and older age (adjOR = 1.09, = 0.006); but decreased with more depressive symptoms (adjOR = 0.79, < 0.001).

    Conclusions: The results highlight a collection of ICF body functions, activities and personal factors associated with higher SRH among community-dwelling older people. Some of these, such as physical capacity, depressive symptoms, and habitual physical activity are of particular interest due to their potential for change through public health interventions. The use of ICF conceptual framework and widely accepted standardized assessments should make these results comparable and relevant in an international context.

  • 111.
    Arnadottir, Solveig A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsdottir, Elin D
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Participation frequency and perceived participation restrictions at older age: applying the International Classification of Functioning, Disability and Health (ICF) framework2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 23-24, p. 2208-2216Article in journal (Refereed)
    Abstract [en]

    Purpose: To identify variables from different components of International Classification of Functioning, Disability and Health (ICF) associated with older people's participation frequency and perceived participation restrictions. Method: Participants (N = 186) were community-living, 65-88 years old and 52% men. The dependent variables, participation frequency (linear regression) and perceived participation restrictions (logistic regression), were measured using The Late-Life Function and Disability Instrument. Independent variables were selected from various ICF components. Results: Higher participation frequency was associated with living in urban rather than rural community (beta = 2.8, p < 0.001), physically active lifestyle (beta = 4.6, p < 0.001) and higher cognitive function (beta = 0.3, p = 0.009). Lower participation frequency was associated with being older (beta = -0.2, p = 0.002) and depressive symptoms (beta = -0.2, p = 0.029). Older adults living in urban areas, having more advanced lower extremities capacity, or that were employed had higher odds of less perceived participation restrictions (adjusted odds ratio [OR] = 5.5, p = 0.001; OR = 1.09, p < 0.001; OR = 3.7, p = 0.011; respectively). In contrast, the odds of less perceived participation restriction decreased as depressive symptoms increased (OR = 0.8, p = 0.011). Conclusions: Our results highlight the importance of capturing and understanding both frequency and restriction aspects of older persons' participation. ICF may be a helpful reference to map factors associated with participation and to study further potentially modifiable influencing factors such as depressive symptoms and advanced lower extremity capacity.

  • 112.
    Arnadottir, Solveig A
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsdottir, Elin D
    Fisher, Anne G
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Application of rasch analysis to examine psychometric aspects of the activities-specific balance confidence scale when used in a new cultural context2010In: Archives of Physical Medicine and Rehabilitation, ISSN 0003-9993, E-ISSN 1532-821X, Vol. 91, no 1, p. 156-163Article in journal (Refereed)
    Abstract [en]

    Arnadottir SA, Lundin-Olsson L, Gunnarsdottir ED, Fisher AG. Application of Rasch analysis to examine psychometric aspects of the Activities-Specific Balance Confidence Scale when used in a new cultural context. OBJECTIVE: To investigate by using Rasch analysis the psychometric properties of the Activities-Specific Balance Confidence (ABC) Scale when applied in a new Icelandic context. DESIGN: Cross-sectional, population-based, random selection from the Icelandic National Registry. SETTING: Community-based. PARTICIPANTS: Icelanders (N=183), 65 to 88 years old, and 48% women. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: ABC, an instrument used to evaluate how confident older people are in maintaining balance and remaining steady when moving through the environment. An Icelandic translation of the ABC (ABC-ICE) scale was evaluated by implementing Rasch rating scale analysis to transform ordinal ABC-ICE scores into interval measures and evaluating aspects of validity and reliability of the scale. RESULTS: Participants were not able to differentiate reliably between the 11 rating scale categories of the ABC-ICE. Additionally, 3 items failed to show acceptable goodness of fit to the ABC-ICE rating scale model. By collapsing categories and creating a new 5-category scale, only 1 item misfit. Removing that item resulted in a modified version of ABC-ICE with 5 categories and 15 items. Both item goodness-of-fit statistics and principal components analysis supported unidimensionality of the modified ABC-ICE. The ABC-ICE measures reliably separated the sample into at least 4 statistically distinct strata of balance confidence. Finally, the hierarchical order of item difficulties was consistent with theoretic expectations, and the items were reasonably well targeted to the balance confidence of the persons tested. CONCLUSIONS: Rasch analysis indicated a need to modify the ABC-ICE to improve its psychometric properties. Further studies are needed to determine if similar analyses of other versions of the ABC, including the original one, will yield similar results.

  • 113.
    Arnadottir, Solveig
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Gunnarsdottir, E
    Stenlund, Hans
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lundin-Olsson, Lillemor
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Self-rated health: a valid outcome in geriatric physical therapy?Article in journal (Refereed)
  • 114.
    Arnadóttir, Gudrún
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Occupational Therapy.
    Impact of Neurobehavioral Deficits on Activities of Daily Living2004In: Stroke rehabilitation: A function-based approach, St. Louis, MO, USA: CV Mosby Company , 2004, p. 376-426Chapter in book (Other academic)
  • 115.
    Arnadóttir, Gudrún
    et al.
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation, Occupational Therapy.
    Fisher, Anne
    Umeå University, Faculty of Medicine, Community Medicine and Rehabilitation.
    Rasch analysis of the ADL scale of the A-ONE.2008In: American Journal of Occupational Therapy, ISSN 0272-9490, Vol. 62, no 1, p. 51-60Article in journal (Other academic)
  • 116. Arne, Mats
    et al.
    Emtner, Margareta
    Lisspers, Karin
    Wadell, Karin
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Stallberg, Bjorn
    Availability of pulmonary rehabilitation in primary care for patients with COPD: a cross-sectional study in Sweden2016In: EUROPEAN CLINICAL RESPIRATORY JOURNAL, ISSN 2001-8525, Vol. 3, article id 31601Article in journal (Refereed)
    Abstract [en]

    Background: Pulmonary rehabilitation (PR) is an important, evidence-based component for the management of individuals with chronic obstructive pulmonary disease (COPD). In daily practice, the majority of COPD patients are treated in primary care. However, information about the availability of PR in primary care in Sweden is lacking. The aim was to investigate the availability of rehabilitation resources in primary care settings for patients with COPD in Sweden. Methods: A cross-sectional descriptive design was applied, using web-based questionnaires sent to all primary care centres in four regions, comprising more than half of the 9.6 million inhabitants of Sweden. The main questionnaire included questions about the content and availability of rehabilitation resources for COPD patients. PR was defined as exercise training and one or more of the following activities: education, nutritional intervention, energy conservation techniques or psychosocial support. Results: A total of 381 (55.9%) of the 682 primary care centres answered the main questionnaire. In addition to physicians and nurses, availability of healthcare professionals for rehabilitation in primary care settings was physiotherapists 92.0%, occupational therapists 91.9%, dieticians 83.9% and social workers or psychologists 98.4%. At 23.7% of all centres, PRwas not available toCOPD patients - neither in primary care nor at hospitals. Conclusion: Despite high availability of professionals for rehabilitation in primary care settings, about one-quarter of managers at primary care centres stated that their COPD patients had no access to PR. This indicates a need to structure resources for rehabilitation and to present and communicate the available resources within the healthcare system.

  • 117.
    Arnemo, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Förenklad vardag -­ utveckling av enapplikation tillsammans med ungavuxna med ryggmärgsbråck: En kvalitativ studie2014Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
    Abstract [sv]

    Applikationer i mobiltelefoner är vanligt som teknikstöd för att underlätta i vardagen. Det kan varakomplicerat att lära sig att nyttja alla funktioner, speciellt om man har nedsatt kognitiv förmåga. Personermed ryggmärgsbråck har kognitiva svårigheter vilket kan begränsa möjligheten till att vara aktiv ochdelaktig i samhället. Syftet med studien var att beskriva utformning av design och funktion i enapplikation utifrån erfarenheter i vardagen hos unga vuxna med ryggmärgsbråck. Fem personer (17-­ 24år) med ryggmärgsbråck deltog i studien. En kvalitativ metod, Participatory Action Research (PAR),användes för att i samarbete med deltagarna utveckla en applikation. Datainsamlingen bestod av två delaroch inleddes med semistrukturerade individuella intervjuer med bedömningsinstrumentet CanadianOccupational Performance Measure (COPM) och därefter genomfördes fokusgruppsintervjuer vid fyratillfällen under utvecklingsperioden. Analys av data har skett i flera steg. En sammanställning utifrånCOPM-­intervjuerna utgjorde en grund inför fokusgruppsintevjuerna. De transkriberadefokusgruppsintevjuerna har bearbetats och analyserats genom kvalitativ innehållsanalys. Analysen􀁕􀁈􀁖􀁘􀁏􀁗􀁈􀁕􀁄􀁇􀁈􀀃􀁌􀀃􀁉􀁼􀁏􀁍􀁄􀁑􀁇􀁈􀀃􀁗􀁈􀁐􀁄􀁑􀀃􀂴􀀰􀁈􀁇􀁙􀁈􀁗􀁈􀁑􀁋􀁈􀁗􀀃􀁒􀁐􀀃􀁅􀁈􀁊􀁕􀁬􀁑􀁖􀁑􀁌􀁑􀁊􀁄􀁕􀀃􀁌􀀃􀁙􀁄􀁕􀁇􀁄􀁊􀁈􀁑􀂴􀀏􀀃􀂴􀀷􀁈􀁎􀁑􀁌􀁎􀁖􀁗􀁼􀁇􀀃􀁘􀁑􀁇􀁈􀁕􀁏􀁬􀁗􀁗􀁄􀁕􀀃􀁌􀁑􀁗􀁈􀀃􀁄􀁏􀁏􀁗􀁌􀁇􀂴􀀃􀁒􀁆􀁋􀀃􀂴􀀨􀁑􀁊􀁄􀁊􀁈􀁕􀁄􀁇􀁈􀀃􀁌􀀃􀁇􀁈􀁖􀁌􀁊􀁑􀀃􀁒􀁆􀁋􀀃􀁉􀁘􀁑􀁎􀁗􀁌􀁒􀁑􀁄􀁏􀁌􀁗􀁈􀁗􀁈􀁕􀂴􀀑􀀃􀀵􀁈􀁖􀁘􀁏􀁗􀁄􀁗􀁈􀁗 visade också att deltagarna var välmedvetna om sina svårigheter och hur det påverkade deras vardag. Utifrån sina erfarenheter komdeltagarna med värdefulla synpunkter vilket medförde ett par nya förslag till funktioner och att designenutvecklades till att den baserades mer på gester än knapptryck. Detta för att snabbt komma in i den ochför att få större utrymmen att navigera i applikationen. Resultatet visar på betydelsen av att personer medfunktionsnedsättning är med i utformning av applikationer. Smartphones ger en ökad flexibilitet och harpotential att bli en plattform för framtida utveckling.

  • 118.
    Arnqvist, Jonna
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Mo Gustavsson, Matilda
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Occupational Therapy.
    Arbetsterapeuters erfarenheter från utredning av barn och ungdomar i behov av kognitivt stöd: -En kvalitativ intervjustudie2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Barn och ungdomar med kognitiva svårigheter kan uppleva aktivitetsbegränsningar och delaktighetsinskränkningar. Det finns ett flertal kognitiva hjälpmedel vilka kan hjälpa barn och ungdomar att känna självsäkerhet och få ökad kontroll i sin vardag. Arbetsterapeuten har en viktigt roll att möjliggöra en fungerande vardag, i detta arbete ingår bland annat utredning och förskrivning av hjälpmedel. Syftet med denna studie var att beskriva arbetsterapeuters erfarenheter från initiering och genomförande av utredning för barn och ungdomar i behov av kognitivt stöd. Semistrukturerade intervjuer genomfördes med sex legitimerade arbetsterapeuter verksamma inom Barn- och ungdomshabilitering i Västerbotten. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys och resulterade i 3 huvudkategorier; Arbetsterapeutens uppdrag, Nätverket- en avgörande faktor samt Flexibilitet hos arbetsterapeuten skapar delaktighet under utredningen. Resultatet visar att den arbetsterapeutiska utredningen är en dynamisk process där arbetsterapeuten hela tiden anpassar sig själv med hänsyn till personen som utreds. Utifrån studiens resultat går det även dra slutsatsen att föräldrarnas roll i utredningen och implementeringen av kognitivt stöd har stor inverkan på utredningens kvalitet och för att barnen ska bli självständiga och trygga i användandet av sitt stöd.

  • 119.
    Arumugam, Ashokan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Clinical versus radiological findings: A paradox in diagnosing minor hamstring injuries2018In: International Journal of Osteopathic Medicine, ISSN 1746-0689, E-ISSN 1878-0164, Vol. 27, p. 52-56Article in journal (Refereed)
    Abstract [en]

    Hamstring injuries occur commonly in athletes participating in sports that require sprinting/high velocity running, kicking a ball or agility. In the first instance, clinical assessment and management play a pivotal role in managing these injuries. Radiological investigations such as ultrasonography (US) and magnetic resonance imaging (MRI) are also recommended to confirm one or more parameters related to hamstring injury (the location, length, cross-sectional area, volume, edema, hemorrhage, etc.) and predicting return-to-play. However, hamstring injuries that are minor in nature, diagnosed clinically, may not be discernible on conventional US or MRI in some cases. Certain reasons for these paradoxical (clinical vs. radiological) findings may include pain referral to the posterior thigh from lumbosacral dysfunction or sciatic nerve pathoneurodynamics. Conversely, minor hamstring injuries might remain indiscernible within the threshold of conventional MRI sensitivity. To date, there is neither clear consensus on a standardized criteria nor strong evidence for using MRI to prognosticate return-to-play following hamstring injuries. This paper briefly discusses the controversy between contradicting clinical and radiological findings encountered by clinicians in the diagnosis of minor hamstring injuries. If posterior thigh pain appears with clinical signs and symptoms of a minor hamstring injury without pain referral from neighboring structures, but presents with negative findings on US or MRI, the diagnosis remains a challenge. However, such conditions are pragmatically treated as (nonstructural) hamstring injuries unless certain differential diagnoses can be established. 

  • 120.
    Arumugam, Ashokan
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Sacral Osteosarcoma Masquerading as Posterior Thigh Pain2018In: Journal of Orthopaedic and Sports Physical Therapy, ISSN 0190-6011, E-ISSN 1938-1344, Vol. 48, no 8, p. 665-665Article in journal (Other academic)
  • 121.
    Arumugam, Ashokan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Markström, Jonas L.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Häger, Charlotte K.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Introducing a novel test with unanticipated medial/lateral diagonal hops that reliably captures hip and knee kinematics in healthy women2019In: Journal of Biomechanics, ISSN 0021-9290, E-ISSN 1873-2380, Vol. 82, p. 70-79Article in journal (Refereed)
    Abstract [en]

    Despite a vast literature on one-leg hops and cutting maneuvers assessing knee control pre/post-injury of the anterior cruciate ligament (ACL), comprehensive and reliable tests performed under unpredictable conditions are lacking. This study aimed to: (1) assess the feasibility of an innovative, knee-challenging, one-leg double-hop test consisting of a forward hop followed by a diagonal hop (45°) performed medially (UMDH) or laterally (ULDH) in an unanticipated manner; and (2) determine within- and between-session reliability for 3-dimensional hip and knee kinematics and kinetics of these tests. Twenty-two healthy women (22.3 ± 3.3 years) performed three successful UMDH and ULDH, twice 1–4 weeks apart. Hop success rate was 69–84%. Peak hip and knee angles demonstrated moderate to excellent within-session reliability (intraclass correlation coefficient [ICC] 95% confidence interval [CI]: 0.67–0.99, standard error of measurement [SEM] ≤  3°) and poor to excellent between-session reliability (ICC CI: 0.22–0.94, SEM ≤ 3°) for UMDH and ULDH. The smallest real difference (SRD) was low (≤ 5°) for nearly all peak angles. Peak hip and knee moments demonstrated poor to excellent reliability (ICC CI: 0–0.97) and, in general, moments were more reliable within-session (SEM ≤ 0.14 N.m/kg.m, both directions) than between-session (SRD ≤ 0.43 N.m/kg.m). Our novel test was feasible and, in most but not all cases, provided reliable angle estimates (within-session > between-session, both directions) albeit less reliable moments (within-session > between-session, both directions). The relatively large hip and knee movements in the frontal and transverse planes during the unanticipated hops suggest substantial challenge of dynamic knee control. Thus, the test seems appropriate for evaluating knee function during ACL injury rehabilitation.

  • 122.
    Arumugam, Ashokan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Strong, Andrew
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Tengman, Eva
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Röijezon, Ulrik
    Häger, Charlotte
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Psychometric properties of knee proprioception tests targeting healthy individuals and those with anterior cruciate ligament injury managed with or without reconstruction: a systematic review protocol2019In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 4, article id e027241Article, review/survey (Refereed)
    Abstract [en]

    Introduction: An anterior cruciate ligament (ACL) injury affects knee proprioception and sensorimotor control and might contribute to an increased risk of a second ACL injury and secondary knee osteoarthritis. Therefore, there is a growing need for valid, reliable and responsive knee proprioception tests. No previous study has comprehensively reviewed all the relevant psychometric properties (PMPs) of these tests together. The aim of this review protocol is to narrate the steps involved in synthesising the evidence for the PMPs of specific knee proprioception tests among individuals with an ACL injury and knee-healthy controls.

    Methods and analysis: The Preferred Reporting Items for Systematic reviews and Meta-Analyses will be followed to report the review. A combination of four conceptual groups of terms-(1) construct (knee proprioception), (2) target population (healthy individuals and those with an ACL injury managed conservatively or with a surgical reconstruction), (3) measurement instrument (specific knee proprioception tests) and (4) PMPs (reliability, validity and responsiveness)-will be used for electronic databases search. PubMed, AMED, CINAHL, SPORTDiscus, Web of Science, Scopus, the Cochrane Central Register of Controlled Trials and ProQuest will be searched from their inception to November 2018. Two reviewers will independently screen titles, abstracts and full text articles, extract data and perform risk of bias assessment using the updated COnsensus-based Standards for the selection of health Measurement INstruments risk of bias checklist for the eligible studies. A narrative synthesis of the findings and a meta-analysis will be attempted as appropriate. Each PMP of knee proprioception tests will be classified as 'sufficient', 'indeterminate' or 'insufficient'. The overall level of evidence will be ascertained using an established set of criteria.

    Ethics and dissemination: Ethical approval or patient consent is not required for a systematic review. The review findings will be submitted as a series of manuscripts for peer-review and publication in scientific journals.

  • 123.
    Asarheim, Rasmus
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rösmark Sundvall, Magnus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Rörelseomfångets betydelse för akut muskulär trötthet2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Syfte: Syftet med studien var att jämföra styrketräning utfört med ett begränsat- kontra fullt rörelseomfång avseende akut muskulär trötthet.  

    Metod: Tio frivilliga deltagare fick vid två separata tillfällen utföra sittande bicepscurls, en gång med fullt- (ca 10-130°) en gång med begränsat rörelseomfång (ca 90-130°). MVC-mätning utfördes före, 1, 5, och 10 minuter efter avslutat arbete för att ta reda på förlusten av maximal styrkekapacitet. CR100 skattning av smärta skedde före och 3 minuter efter avslutat arbete.    

    Resultat: Det fanns en signifikant skillnad i akut muskulär trötthet jämfört med en utprovad baslinje för samtliga deltagare efter utfört arbete, både vid ett begränsat- och fullt rörelseomfång. Det fanns ingen signifikant skillnad i muskulär trötthet mellan begränsat- och fullt rörelseomfång vid 1 samt 10 minuter efter utfört arbete. En signifikant skillnad noterades dock vid 5 minuter efter utfört arbete, återhämtningen var då långsammare vid ett fullt rörelseomfång. Ingen signifikant skillnad avseende uppskattad smärta fanns mellan begränsat- och fullt rörelseomfång.    

    Slutsats: Den signifikanta skillnad som observerades vid 5-minutersmarkören speglade inte den akuta muskulära tröttheten då denna enbart infinner sig 1-2 minuter efter avslutat arbete. Effekten var större vid ett fullt rörelseomfång, vilket tyder på att detta skulle vara bättre än ett begränsat rörelseomfång för muskulär tillväxt. Eventuella fördelar med ett begränsat rörelseomfång finns troligen, men det krävs mer forskning inom området. I övrigt verkar smärta i muskler under återhämtning svår att skatta.

  • 124.
    Asklöf, Kajsa
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Bildövningar med natur baserade på en narrativ litteraturöversikt av bildterapi, trädgårdsterapi och mindfulness2016Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The main purpose of this narrative literature review is to examine the evidence that can be used to construct assignments in and with nature for art therapy in horticultural therapy and other forms of treatment and rehabilitation where nature is a central part. The reason for this is to make nature a coherent theme throughout the rehabilitation. The theoretical framework is based on several different theories as art therapy in horticultural therapy is not yet thoroughly investigated. The result is constructed from findings in literature, theories and research about art therapy, horticultural therapy and other forms of nature based therapy, and mindfulness and is combined with inspiration from land art. The result is the findings of evidence for the different forms of treatment and suggestions of assignments that can be done outdoors with a group.

  • 125.
    Aspdahl, Magnus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Comparison of joint status with ultrasound and physical examination in children with hemophilia A2016Independent thesis Advanced level (degree of Master (Two Years)), 20 credits / 30 HE creditsStudent thesis
    Abstract [en]

    Introduction: Hemophilia A is a bleeding disorder that can cause chronic artropathy, when not treated optimally. To detect early signs of hemophilic artropathy patients with moderate or severe hemophilia undergo yearly examinations by a physiotherapist defining the joint status by a scoring system, “HJHS”. A new ultrasound-based scoring system, HEAD-US, has been developed to evaluate joint disease progression and treatment results. The aim of this study is to evaluate if there is a correlation between HJHS 2.1 and HEAD-US in children with hemophilia A. Furthermore, to evaluate if there is a correlation between physical activity and hemophilic artropathy and finally to asses if there are any differences in artropathy between sub-groups within the study group.

    Methods: A prospective study where all patients between ages 3 to 18 years with moderate or severe hemophilia followed at the Karolinska University Hospital 2015-2016 were asked to participate. Patients were asked to fill in a questionnaire regarding physical activity and joint bleeds and clinical data were retrospectively collected from the patients’ medical records. Joints were evaluated by the author according to HJHS and HEAD-US.

    Results: There was a significant correlation between the total-, elbow-, knee- and ankle scores for HJHS and HEAD-US scores. There was a statistically significant correlation between annual bleeding rate and total scores for HJHS and HEAD-US. No statistically significant correlation was seen between the total score of HJHS or HEAD-US and the level of physical activity.

    Conclusions: This study demonstrates that the total score and individual joint scores with HEAD-US correlate well with the current method HJHS 2.1 in children with hemophilia A. 

  • 126.
    Asplund, Kjell
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Bernspång, Birgitta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    [Perceptual impairment].1989In: Nordisk Medicin, ISSN 0029-1420, Vol. 104, no 11, p. 276-7, 304Article in journal (Other academic)
    Abstract [sv]

    After a brain injury, whether traumatic or caused by a stroke, perceptual impairments are common. They are, however, only seldom revealed by a routine physical examination. In this article, the many manifestations of perceptual impairment and tests for perceptual function are briefly presented. It appears that perceptual deficits contribute largely to reduced self-care ability in patients with brain lesions. An effective training program for perceptual deficits remains to be developed.

  • 127.
    Atmarsson, Kamilla
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    När är en människa död?: En studie av den juridiska definitionen av döden2012Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Fram till den 1 januari 1988 saknade Sverige rättsregler som angav när en människa skulle anses vara död. Innan år 1984 hade inte heller frågan om dödsbegreppet lyfts till analys. I medicinsk przis hade emellertid döden sedan länge ansetts träda in vid det tillfälle då en människas hjärt- och andningsverksamhet varaktigt upphört. Under intensivsvårdens växande framsteg på sextio-, sjuttio- och åttiotalen utvecklades dock ett behov av att både ändra den allmänt vedertagna definitionen av dödens inträdande och av att införa en juridiskt bindande definition om när döden ansågs ha inträffat. Efter en omfattande utredning beslutades till sist att lagstadga dödsbegreppet och döden definierades ha inträffat när hjärnans samtliga funktioner totalt och oåterkalleligt fallit bort. Frågan som ställs i denna uppsats är hur dagens definition av döden lyder. Uppsatsen undersöker därav skälen som föranlett den nuvarande definitionen och hur den rent praktiskt går till när döden ska fastställas.

  • 128.
    Awad, Amar
    et al.
    Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Levi, Richard
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
    Lindgren, Lenita
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Hultling, Claes
    Department of Neurobiology, Care Sciences and Society (Neurorehabilitation), Karolinska Institute, Stockholm, Sweden.
    Westling, Göran
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology.
    Nyberg, Lars
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Radiation Sciences.
    Eriksson, Johan
    Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB), Physiology. Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).
    Preserved somatosensory conduction in a patient with complete cervical spinal cord injury2015In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 47, no 5, p. 426-431Article in journal (Refereed)
    Abstract [en]

    Objective: Neurophysiological investigation has shown that patients with clinically complete spinal cord injury can have residual motor sparing ("motor discomplete"). In the current study somatosensory conduction was assessed in a patient with clinically complete spinal cord injury and a novel ethodology for assessing such preservation is described, in this case indicating "sensory discomplete" spinal cord injury. Methods: Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI) was used to examine the somatosensory system in a healthy subject and in a subject with a clinically complete cervical spinal cord injury, by applying tactile stimulation above and below the level of spinal cord injury, with and without visual feedback. Results: In the participant with spinal cord injury, somatosensory stimulation below the neurological level of the lesion gave rise to BOLD signal changes in the corresponding areas of the somatosensory cortex. Visual feedback of the stimulation strongly modulated the somatosensory BOLD signal, implying that cortico-cortical rather than spino-cortical connections can drive activity in the somatosensory cortex. Critically, BOLD signal change was also evident when the visual feedback of the stimulation was removed, thus demonstrating sensory discomplete spinal cord injury. Conclusion: Given the existence of sensory discomplete spinal cord injury, preserved but hitherto undetected somatosensory conduction might contribute to the unexplained variability related to, for example, the propensity to develop decubitus ulcers and neuropathic pain among patients with clinically complete spinal cord injury.

  • 129.
    Axelryd, Gustaf
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Zeising, Fredrik
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samband mellan felställningar i fot, knä och höft och patellofemoralt smärtsyndrom: En systematisk litteraturgranskning2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Patellofemoralt smärtsyndrom (PFPS) är en diagnos som avser smärta i främre delen av knät och i patellofemoralleden. Överbelastning, onormal patellarörlighet, onormal Q-vinkeln, muskelsvaghet, muskelstramhet, muskelobalans och felställningar har föreslagits som riskfaktorer till PFPS. Trots att flera studier har undersökt sambandet mellan felställningar och PFPS är sambandet fortfarande oklart.

    Syfte: Syftet med denna systematiska litteraturstudie var att undersöka statiska felställningar i fot, knä och höft som kan ha ett samband med PFPS.

    Metod: En litteratursökning genomfördes i september 2013 i databaserna, Pubmed (med Medline), CINAHL (med fulltext), SPORTDiscus, Academic Search Elite, Web of Science, Scopus och Pedro.  Efter granskning av ingående artiklar användes GRADE för att bedöma den sammanvägda evidensen av de enskilda utfallsmåtten.

    Resultat: Fjorton artiklar inkluderades i granskningen. Studierna hade undersökt 16 olika utfallsmått. Navicular drop, vinkel Calcaneus – lodlinjen, navicular drift, pes planus, vinkel calcaneus-tibia, foot posture index, lateral distal femur angel och medial proximal tibia angel bedömdes med hjälp av GRADE. Den sammanlagda evidensen enligt GRADE ansågs vara låg, och visade på ”otillräckligt vetenskapligt stöd” för ett samband mellan statiska felställningar i fot, knä och höft och PFPS.

    Slutsats: Det behövs fler studier med högre kvalitet för att utreda samband mellan statiska felställningar och PFPS. 

  • 130.
    Axelsson, Helena
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ridderström, Ida
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Is Pilates more effective than a Motor Control Exercise program when treating chronic low back pain: A randomised Control Trial2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 131.
    Axelsson, Lovisa
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Olovsson, Jessica
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Strategier för att motivera personer med förvärvade ryggmärgsskador: En kvalitativ studie om arbetsterapeuters professionella resonemang2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
  • 132.
    Axén, Malin
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Stålnacke, Hanna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
    Upplevelser av en multidisciplinär grupputbildning för patienter med diabetes typ II: En kvalitativ studie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Det finns god evidens för att patientutbildning i grupp har bra effekt på långtidssocker (HbA1c) hos patienter med diabetes typ II. Det är dock ovisst om sådan grupputbildning är genomförbar i primärvård och hur den i så fall bör utformas. För att undersöka detta har det startats ett pilotprojekt med en grupputbildning på en vårdcentral i Västerbottens län.

    Syfte: Att studera deltagarnas upplevelser av en multidisciplinär grupputbildning för patienter med diabetes typ II, inom primärvården.

    Metod: Semistrukturerade intervjuer utfördes med fyra informanter, som deltagit i grupputbildningen. Öppna frågor ställdes kring de ämnen som utbildningen behandlat samt huruvida informanterna gjort förändringar efter kursen. Intervjuerna analyserades med kvalitativ innehållsanalys.

    Resultat: Studien resulterade i fyra kategorier. Onödig undervisning men användbara tips: den teoretiska undervisningen upplevdes onödig, men konkreta tips var givande för att uppnå livsstilsförändringar. Viljan att lära av och stötta varandra: att få ta del av varandras erfarenheter ansågs vara det viktigaste i utbildningen. Känsla av otillräcklighet: de förändringar informanterna gjort sågs som otillräckliga och ibland för små för att nämna. Förnekar som skydd och söker efter hopp: skam, hopplöshet och en rädsla för framtiden uttrycktes. Förnekelse användes som försvarsmekanism samtidigt som informanterna sökte hopp om att kunna må bra.

    Slutsats: Resultatet antyder att en grupputbildning bör ge utrymme för deltagarna att utbyta erfarenheter. För informanterna var det viktigt att utbildningen ingav hopp om att kunna må bra. Det uppskattades att utbildningen bistod med konkreta tips om hur deltagarna kunde gå tillväga för att nå de övergripande livsstilsmålen.

  • 133.
    Backeström, Anna
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Nilsson, Lars-Göran
    Olsson, Tommy
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Rolandsson, Olov
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
    Glucose but not insulin or insulin resistance is associated with memory performance in middle-aged non-diabetic women: a cross sectional study2015In: Diabetology and Metabolic Syndrome, ISSN 1758-5996, E-ISSN 1758-5996, Vol. 7, article id 20Article in journal (Refereed)
    Abstract [en]

    Background: Elevated concentrations of plasma glucose appear to play a role in memory impairment, and it has been suggested that insulin might also have a negative effect on cognitive function. Our aim was to study whether glucose, insulin or insulin resistance are associated with episodic or semantic memory in a non-diabetic and non-demented population. 

    Methods: We linked and matched two population-based data sets identifying 291 participants (127 men and 164 women, mean age of 50.7 +/- 8.0 years). Episodic and semantic memory functions were tested, and fasting plasma insulin, fasting plasma glucose, and 2-hour glucose were analysed along with other potential influencing factors on memory function. Since men and women display different results on memory functions they were analysed separately. Insulin resistance was calculated using the HOMA-IR method. 

    Results: A higher fasting plasma glucose concentration was associated with lower episodic memory in women (r = -0.08, 95% CI -0.14; -0.01), but not in men. Plasma insulin levels and insulin resistance were not associated with episodic or semantic memory in women or in men after adjustments for age, fasting glucose, 2-hour glucose, BMI, education, smoking, cardiovascular disease, hypertension, cholesterol, and physical activity. 

    Conclusions: This indicates that fasting glucose but not insulin, might have impact on episodic memory in middle-aged women.

  • 134.
    Backman, Anders
    et al.
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Bodin, Kenneth
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Bucht, Gösta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Janlert, Lars-Erik
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Maxhall, Marcus
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Pederson, Thomas
    Innovative Communication Group, IT University of Copenhagen.
    Sjölie, Daniel
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    Sondell, Björn
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Surie, Dipak
    Umeå University, Faculty of Science and Technology, Department of Computing Science.
    easyADL – Wearable Support System for Independent Life despite Dementia2006In: ACM CHI 2006 Workshop onDesigning Technology for People with Cognitive Impairments, 2006Conference paper (Refereed)
    Abstract [en]

    This position paper outlines the easyADL project, a two-year project investigating the possibility of using wearable technology to assist people suffering the dementia disease in performing Activities of Daily Living (ADL). An introduction to the egocentric interaction modeling framework is provided and the virtual reality based development methodology is discusssed.

  • 135.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Ahnlund, Petra
    Umeå University, Faculty of Social Sciences, Department of Social Work.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    McGilton, Katherine S.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia .
    Leading towards person-centred care – Nursing home managers' experiences of leading person-centred care in highly person-centred Swedish nursing homesManuscript (preprint) (Other academic)
    Abstract [en]

    Background:Although a growing body of research knowledge exists highlighting the importance of leadership for person-centred care, studies focused on nursing home managers’ own descriptions of leading their staff to provide person-centred care is lacking. This study aims to explore the process of nursing home managers’ leading person-centred care in Swedish nursing homes.

    Methods:The methods of the study consisted of semi-structured interviews with 12 nursing home managers within 11 highly person-centred nursing homes purposively selected from a national wide survey of nursing homes in Sweden. A qualitative content analysis was performed for data analyses.

    Results:The study revealed that the leading person-centred care in nursing homes can be outlined as comprising four processes: Embodying person-centred being and doing; promoting a person-centred atmosphere; maximizing person-centred team potential; and finally, optimizing person-centred support structures.

    Conclusion:This study contributes to the literature by providing concrete descriptions of how person-centred care can be operationalised and supported in everyday practice by the leadership of nursing home managers. The study is significant in that it provides evidence on how the provision of person centred care can be facilitated by managers and the important role they play in developing and maintaining this philosophy of care within nursing homes.

  • 136.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Nursing. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing.  School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
    Characteristics of highly rated leadership in Swedish nursing homes2016In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 56, p. 283-283Article in journal (Other academic)
  • 137.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health. Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia.
    Characteristics of highly rated leadership in nursing homes using item response theory2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2903-2913Article in journal (Refereed)
    Abstract [en]

    Aim: To identify characteristics of highly rated leadership in nursing homes. Background: An ageing population entails fundamental social, economic and organizational challenges for future aged care. Knowledge is limited of both specific leadership behaviours and organizational and managerial characteristics which have an impact on the leadership of contemporary nursing home care. Design: Cross-sectional. Method: From 290 municipalities, 60 were randomly selected and 35 agreed to participate, providing a sample of 3605 direct-care staff employed in 169 Swedish nursing homes. The staff assessed their managers' (n = 191) leadership behaviours using the Leadership Behaviour Questionnaire. Data were collected from November 2013 - September 2014, and the study was completed in November 2016. A two-parameter item response theory approach and regression analyses were used to identify specific characteristics of highly rated leadership. Results: Five specific behaviours of highly rated nursing home leadership were identified; that the manager: experiments with new ideas; controls work closely; relies on subordinates; coaches and gives direct feedback; and handles conflicts constructively. The regression analyses revealed that managers with social work backgrounds and privately run homes were significantly associated with higher leadership ratings. Conclusion: This study highlights the five most important leadership behaviours that characterize those nursing home managers rated highest in terms of leadership. Managers in privately run nursing homes and managers with social work backgrounds were associated with higher leadership ratings. Further work is needed to explore these behaviours and factors predictive of higher leadership ratings.

  • 138.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lindkvist, Marie
    Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifer y, La Trobe University, Melbourne, VIC, Australia.
    Towards person-centredness in aged-care: exploring the impact of leadership2016In: Journal of Nursing Management, ISSN 0966-0429, E-ISSN 1365-2834, Vol. 24, no 6, p. 766-774Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the association between leadership behaviours among managers in aged care, and person‐centredness of care and the psychosocial climate.

    Background: Theory suggests that leadership is important for improving person‐centredness in aged care, however, empirical evidence is lacking.

    Methods: A cross‐sectional design was used to collect data from Swedish aged care staff (= 3661). Valid and reliable questionnaires assessing leadership behaviours, person‐centeredness of care and the psychosocial climate were used. Data were analysed using multiple linear regression including interaction terms.

    Results: Leadership behaviours were significantly related to the person‐centredness of care and the psychosocial climate. The level of person‐centredness of care moderated the impact of leadership on the psychosocial climate.

    Conclusions and implications for nursing management: The leadership behaviour of managers significantly impacts person‐centred care practice and contributes to the psychosocial climate for both staff and residents in aged care. This study is the first empirically to confirm that middle managers have a central leadership role in developing and supporting person‐centred care practice, thereby creating a positive psychosocial climate and high quality care.

  • 139.
    Backman, Annica
    et al.
    Umeå University, Faculty of Medicine, Department of Nursing.
    Sjögren, Karin
    Umeå University, Faculty of Medicine, Department of Nursing.
    Lövheim, Hugo
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
    Edvardsson, David
    Umeå University, Faculty of Medicine, Department of Nursing. School of Nursing and Midwifery, La Trobe University, Melbourne, Vic., Australia.
    Job strain in nursing homes: exploring the impact of leadership2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 7-8, p. 1552-1560Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To explore the association between nursing home managers' leadership, job strain and social support as perceived by direct care staff in nursing homes.

    Background: It is well known that aged care staff experience high levels of job strain, and that aged care staff experiencing job strain are exposed to increased risk for adverse health effects. Leadership styles have been associated with job strain in the literature; however, the impact of perceived leadership on staff job strain and social support has not been clarified within nursing home contexts.

    Design: This study had a cross‐sectional design.

    Methods: Participating staff (n = 3,605) completed surveys which included questions about staff characteristics, valid and reliable measures of nursing home managers' leadership, perceived job strain and social support. Statistical analyses of correlations and multiple regression analysis with interaction terms were conducted.

    Results: Nursing home managers' leadership were significantly associated with lower level of job strain and higher level of social support among direct care staff. A multiple regression analysis including an interaction term indicated individual and joint effects of nursing home managers' leadership and social support on job strain.

    Conclusions: Nursing home managers' leadership and social support were both individually and in combination associated with staff perception of lesser job strain. Thus, nursing home managers' leadership are beneficial for the working situation and strain of staff.

    Relevance to clinical practice: Promoting a supporting work environment through leadership is an important implication for nursing home managers as it can influence staff perception of job strain and social support within the unit. By providing leadership, offering support and strategies towards a healthy work environment, nursing home managers can buffer adverse health effects among staff.

  • 140.
    Bah, Ibrahima
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Norberg, Tommy
    Vem har kontroll över mitt liv?: En fokusgruppintervju med deltagare från projektet Livsentreprenören2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Ungdomar står inför många utmaningar och förändringar, och det kan under ungdomstiden vara svårt att identifiera sina egna resurser samt utnyttja dessa på bästa sätt. Ett lyckat ungdomsliv kan komma att spela en avgörande roll för det kommande vuxenlivet och det ansvar som kommer med det. Projektet Livsentreprenörens vision är att stödja ungdomar med funktionsnedsättningar att ta till vara på sina resurser, följa sina drömmar och jobba på ett medvetet sätt för sin hälsa och för sin karriär. Syftet med studien var att undersöka upplevelsen av egenkontroll hos ungdomar som deltar i projektet Livsentreprenören. Fem deltagare deltog i en två timmar lång fokusgruppsintervju som spelades in och sedan analyserades utifrån en kvalitativ innehållsanalys. Analysen resulterade i sex kategorier: En känsla av att vara begränsad, frustration över personer i omgivningen och deras brist på tilltro, positiv upplevelse av stöd i vardagen, en känsla av att bli förminskad, hopp om att bemästra drömmar och mål, samt att våga tro på sig själv. Det visade sig att deltagarna ofta kände sig överkörda av personer i deras omgivning. Studiens deltagare upplevde få av de egenskaper vanliga hos de personer som upplever egenkontroll.

  • 141.
    Bailey, Leslie
    et al.
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Engström, Patrik
    Umeå University, Faculty of Science and Technology, Department of Molecular Biology (Faculty of Science and Technology).
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
    Bergström, Sven
    Umeå University, Faculty of Medicine, Department of Molecular Biology (Faculty of Medicine).
    Waldenström, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Chlamydia pneumoniae infection results in generalized bone loss in mice2008In: Microbes and infection, ISSN 1286-4579, E-ISSN 1769-714X, Vol. 10, no 10-11, p. 1175-1181Article in journal (Refereed)
  • 142.
    Bakke-King, Robert
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Johansson, Sara
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Akuta skador och överbelastningsskador inom idrotten: -  En tvärsnittsstudie om följsamhet till rehabilitering, upplevelse av skada samt upplevd smärta2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Introduction: Acute injuries are generally classified as more severe than overuse injuries due to the fact that they often lead to longer time away from sport. This type of classification of severity in research is not deemed appropriate since it often excludes people suffering from overuse injuries. People with overuse injuries usually stay in their sport but participates with pain, reduced function and performance.

    Purpose: The purpose of this study was to examine significant differences between adherence to rehabilitation, cognitive appraisal and perceived pain depending on if a sport injury has occurred acute or due to overuse.  

    Participants: 51 participants answered the questionnaire and 39 (14 women and 25 men) of these were included in the study. The participants were between 16 and 35 years old, suffered from a sport injury and had a rehabilitation program to treat their injury. Based on the diagnosis and description of the injury the participants were separated into two groups, either acute injury or overuse injury.

    Method: A questionnaire including two validated questionnaires, the Rehabilitation Adherence Questionnaire and Cognitive Appraisal Health Scale and an estimation of highest experienced pain were distributed among different sport teams and social media. To investigate if there were any significant differences between the two groups on the examined variables several t-tests and one ANOVA was completed.

    Results: No significant differences were found between the two groups on any of the examined variables. The category threat on the Cognitive Appraisal Health Scale were close to significance (p=0,071) and suggests that people who suffer from an acute injury found their injury to be more threatful.

    Conclusion: If a sport injury has occurred acute or because of overuse doesn't seem to be a singular determinant factor that affects adherence to rehabilitation, cognitive appraisal or perceived pain

  • 143.
    Bakken, Andreas
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lindberg, Greta
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Äldres möjligheter och begränsningar till självbestämmande på särskilt boende: En kvalitativ studie ur arbetsterapeuters perspektiv2014Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Självbestämmande är en viktig faktor som påverkar vårdtagarnas livskvalitet. Det är därför ett viktigt ämne att undersöka och få större förståelse kring. Syftet med studien var att undersöka vilka begränsningar och möjligheter till självbestämmande arbetsterapeuter uppfattar att vårdtagarna på särskilt boende har. Studien genomfördes med en deskriptiv kvalitativ ansats och materialet samlades in med hjälp av semistrukturerade intervjuer. Därefter analyserades materialet med hjälp av kvalitativ innehållsanalys. Informanterna bestod av fem arbetsterapeuter verksamma inom särskilt boende. Analysen presenteras i de tre huvudkategorierna ”Vårdtagarens egna förmågors inverkan på självbestämmandet”, ”Personal- och organisationsfaktorers inverkan på självbestämmande”, ” Olika aktiviteters möjligheter och begränsningar i relation till självbestämmande” och nio underkategorier. Det framkom i studien att informanterna upplevde att viktiga orsaker till begränsningar i vårdtagarnas självbestämmande var vårdtagarnas personliga förmågor, personaltäthet samt omvårdnadspersonalens övriga arbetsuppgifter och engagemang. Det visade sig att sömnrutiner var det område där vårdtagarna hade störst möjlighet till självbestämmande och att individuella aktivitetsönskemål krävde insatser ifrån andra verksamheter. Det krävs mer forskning som undersöker faktorer som påverkar självbestämmande för vårdtagarna inom särskilt boende.

  • 144.
    Balciunaite, Elona
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Forensic Medicine.
    Vad säger skadorna om gärningsmannen?: beydelse i brottsutredningen Gärningsmannaprofilering2010Student paper other, 5 credits / 7,5 HE creditsStudent thesis
    Abstract [sv]

    Vissa typer av brott kräver stora insatser och kunskap för att hitta en gärningsman. Sådana situationer uppstår när ett offer är död och/eller när man har ett seriemord eller till och med när ett offer har svåra skador med är medvetslöst. I vissa fall kan det vara att offret inte vet vem gärningsman är. Man bör inte heller glömma ett levande offer som skadat sig själv.

       Just skadorna som återfinns hos ett offer indikerar en hel del om en gärningsman. Till skillnad från det juridiska begreppet – en skada, som används i brottsrubriceringssyfte[1], så används skadorna som finns på ett offer i utredningsarbetet för att hitta en gärningsman och återskapa ett händelseförlopp. Med andra ord försöker man svara på frågor: vem har begått ett brott, hur och när brottet har begåtts och varför det har begåtts.[2] Själva utredningsarbetet som omfattar gärningsmannaidentifiering kan i vissa komplicerade, allvarliga fall även inkludera en gärningsmannaprofilering. Syftet är att hitta en gärningsman, dvs. även verifiera om det är just den person som begått visst brott – bevissyfte.

       Skadorna bedöms utifrån art, ålder, grad och antal, t.ex. vilken karaktär en skada har, hur den kunde uppkomma osv. Man försöker bedöma utifrån skadornas art eller andra förhållanden om det kan tyda på ett bestämt motiv, planering av brott eller om det handlar om en impulshandling.[3]

    [1] Thomsen, s. 85.

    [2] Ainsworth, s. 17.

    [3] Thomsen, s. 148-153.

  • 145.
    Ballin, Marcel
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Sports Medicine.
    Internet-based exercise for improvingcardiometabolic risk factors in centrally obese older adults2019Independent thesis Advanced level (degree of Master (One Year)), 20 credits / 30 HE creditsStudent thesis
  • 146.
    Ballin, Marcel
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    Lundberg, Emmy
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Sports medicine.
    The effect of 10 weeks of vigorousintensity interval training on visceral adipose tissue in 70-year-old individuals with central obesity: - a randomized controlled trial2018Independent thesis Basic level (degree of Bachelor), 180 HE creditsStudent thesis
  • 147.
    Ballin, Marcel
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Lundberg, Emmy
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Sörlén, Niklas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordström, Peter
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Hult, Andreas
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
    Nordström, Anna
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine. School of Sport Sciences, The Arctic University of Norway, Tromsø, Norway..
    Effects of Interval Training on Visceral Adipose Tissue in Centrally Obese 70-Year-Old Individuals: A Randomized Controlled Trial2019In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 67, no 8, p. 1625-1631Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the effects of 10 weeks of progressive vigorous-intensity interval training as a single intervention on body composition among 70-year-old individuals with central obesity.

    DESIGN: Randomized controlled trial (ClinicalTrials.gov registration No. NCT03450655).

    SETTING: Community-dwelling 70-year-old men and women living in the Umeå municipality in Sweden.

    PARTICIPANTS: Seventy-seven 70-year-old men and women with central obesity (greater than 1 kg visceral adipose tissue [VAT] for women and greater than 2 kg VAT for men).

    INTERVENTION: Participants allocated to the intervention group were offered a 10-week progressive concurrent exercise program performed three times per week. All participants in both groups had received tailored lifestyle recommendations focused on diet and physical activity at one occasion within 12 months prior to trial initiation.

    MEASUREMENTS: The primary outcome was changes in VAT, and secondary outcomes included changes in total fat mass (FM), total lean body mass (LBM), and body mass index.

    RESULTS: Comparing the groups, there were no significant differences in decrease of VAT mass (P = .10), although the intervention group significantly decreased FM by 716 g (P = .01) and gained LBM by 508 g (P = .03), compared to the control group. Furthermore, the effects of the training were significantly greater in the male subcohort (P < .05 for interaction), with positive effects also on VAT and FM, where men in the intervention group decreased VAT by 175 g (P < .05) and FM by 1364 g (P = .004), compared to the male controls.

    CONCLUSIONS: The present trial demonstrates that 10 weeks of progressive vigorous interval training is sufficient to significantly decrease FM in older adults with central obesity, with positive effects also on LBM.

  • 148.
    Balnožan, Stevan
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Isgren, Andreas
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Samband mellan träningsbelastning vid högintensiva cykelintervaller och styrkekapacitet hos yngre, friska och tränade individer: En pilotstudie2016Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Introduktion: Under senare år har olika former av mycket högintensiv intervallträning givits ett ökat intresse. Denna träningsmetod har potential att vara användbar av många. Problematiken idag är att det inte finns någon kliniskt användbar metod för att styra/reglera träningsintensiteten på ett säkert sätt. 

    Syfte: Att undersöka om tester av styrkeprestation vid 30s Chair Stand Test och Isometriskt marklyft kan användas som mått för att reglera intensitet vid högintensiva intervaller.

    Metod: 12 försökspersoner mellan åldrarna 20-30år (6 kvinnor, 6 män)[BR1]  genomförde Borg Cycle Strenght [BR2] Test för att estimera maximal anaerob effekt (Watt) för 30 sekunders cykelarbete (MAnP, Maximal Anaerobic Power). Därutöver genomfördes två styrketester: Isometriskt marklyft och 30s Chair Stand Test. Sambandet mellan kapaciteten i styrketesterna och MAnP analyserades med Pearson`s[BR3]  korrelationstest.

    Resultat: Signifikant korrelation fanns i båda styrketesten i relation till Cycle Strenght Test, (p<0.01, r=0,77 för 30s Chair Stand Test och p<0.05, r=0,61 för det isometriska marklyftet).

    Konklusion: I den här pilotstudien visar resultatet att det finns ett samband mellan prestationsförmågan vid Marklyft respektive 30s Chair Stand Test och maximal prestationsförmåga vid cykling under 30 sekunder hos unga individer. 30s Chair Stand Test visar sig vara ett mer lämpat styrketest än det isometriska marklyftet för att kunna styra träningsintensiteten vid supramaximala 30 sekunders intervaller. Testmetodiken kan vara möjlig för att kunna styra träningsintensiteten. Vidare studier krävs för användning i klinisk miljö exempelvis bland äldre.

  • 149. Bamia, Christina
    et al.
    Orfanos, Philippos
    Juerges, Hendrik
    Schoettker, Ben
    Brenner, Hermann
    Lorbeer, Roberto
    Aadahl, Mette
    Matthews, Charles E.
    Klinaki, Eleni
    Katsoulis, Michael
    Lagiou, Pagona
    Bueno-de-mesquita, H. B.
    Eriksson, Sture
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
    Mons, Ute
    Saum, Kai-Uwe
    Kubinova, Ruzena
    Pajak, Andrzej
    Tamosiunas, Abdonas
    Malyutina, Sofia
    Gardiner, Julian
    Peasey, Anne
    de Groot, Lisette C. P. G. M.
    Wilsgaard, Tom
    Boffetta, Paolo
    Trichopoulou, Antonia
    Trichopoulos, Dimitrios
    Self-rated health and all-cause and cause-specific mortality of older adults: Individual data meta-analysis of prospective cohort studies in the CHANCES Consortium2017In: Maturitas, ISSN 0378-5122, E-ISSN 1873-4111, Vol. 103, p. 37-44Article in journal (Refereed)
    Abstract [en]

    Objectives: To evaluate, among the elderly, the association of self-rated health (SRH) with mortality, and to identify determinants of self-rating health as “at-least-good”.

    Study design: Individual data on SRH and important covariates were obtained for 424,791 European and United States residents, ≥60 years at recruitment (1982–2008), in eight prospective studies in the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES). In each study, adjusted mortality ratios (hazard ratios, HRs) in relation to SRH were calculated and subsequently combined with random-effect meta-analyses.

    Main outcome measures: All-cause, cardiovascular and cancer mortality.

    Results: Within the median 12.5 years of follow-up, 93,014 (22%) deaths occurred. SRH “fair” or “poor” vs. “at-least-good” was associated with increased mortality: HRs 1.46 (95% CI 1·23–1.74) and 2.31 (1.79–2.99), respectively. These associations were evident: for cardiovascular and, to a lesser extent, cancer mortality, and within-study, within-subgroup analyses. Accounting for lifestyle, sociodemographic, somatometric factors and, subsequently, for medical history explained only a modest amount of the unadjusted associations. Factors favourably associated with SRH were: sex (males), age (younger-old), education (high), marital status (married/cohabiting), physical activity (active), body mass index (non-obese), alcohol consumption (low to moderate) and previous morbidity (absence).

    Conclusion: SRH provides a quick and simple tool for assessing health and identifying groups of elders at risk of early mortality that may be useful also in clinical settings. Modifying determinants of favourably rating health, e.g. by increasing physical activity and/or by eliminating obesity, may be important for older adults to “feel healthy” and “be healthy”.

  • 150.
    Bapira, Maher
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Lundström, Jennifer
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
    Arbetsterapeuters arbetsprocess inom beroendevården: En kvalitativ studie inriktad mot personer med substansbrukssyndrom2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    I Sverige har substansbrukssyndrom ökat och från den senaste utredningen av Statens Offentliga utredning från 2011 har över 300 000 personer någon form av missbruk eller beroende. Det finns få studier som beskriver arbetsteapeuters insatser när det kommer till målgruppen och inga som nämner hur arbetsprocessen beskriver från en arbetsterapeuts synvinkel. Syftet med studien var att belysa arbetterapeuters erfarenheter av yrkets arbetsprocess för personer med ett sybstansbrukssyndrom. I studien användes en kvalitativ metod där sju arbetsterapeuter i olika delar av Sverige intervjuades, data analyserades med tematisk innehållsanalys och resulterade i tre övergripande teman; arbetsterapeuters tillvägagångssätt i arbetsprocessen, komponenter som påverkar arbetsprocessen, och tillgångar och restriktioner som påverkar arbetsprocessen. Ur resultatdiskussionen framkom det att arbetsprocessen är komplex där arbetsterapeuten behöver utreda flera aspekter av klientens aktivitetsmönster och kontinuerlig kontakt med andra professioner behövs för att klientens ska återfå en strukturerad vardag. Sammanfattningsvis behövs mer forskning om arbetsterapeuters insatser för personer med substansbrukssyndrom. 

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